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Examiner: Marathon runner had disease

The Arkansas medical examiner’s office announced Tuesday the cause of death for a University of Wisconsin graduate student who died shortly after completing a marathon last month.

Dr. Stephen Erickson, associate medical examiner for the state of Arkansas, said Adam Nickel, 27, had a congenital heart defect that had gone unnoticed his whole life.

Nickel collapsed suddenly March 2 after finishing the Little Rock Marathon between 11 a.m. and 12 p.m., according to race director Gina Marchese Pharis. He was taken to a nearby hospital and declared dead on arrival.

According to Erickson, Nickel had fibromuscular dysplasia. The very small coronary arteries that carried oxygenated blood to Nickel’s heart were very narrow. This meant not enough blood was getting to his heart while he was running the marathon.

Erickson added Nickel was probably unaware there was anything wrong with his heart until the cardiac episode hit him “like a lightning bolt out of the blue.”

“In all likelihood, Mr. Nickel never had a symptom of this until his death,” Erickson said. “It was the combination of the standard stress on the body and electrolyte fluctuations that occur while running a marathon and an undiagnosed, silent, strange little disease that caused a sudden, catastrophic cardiac event that caused his death.”

Except for the undiagnosed heart condition, Nickel was in perfect shape to handle the long distance of a marathon, Erickson added.

“There is no doubt in my mind that he was physiologically capable of running marathons,” Erickson said. “There was nothing grossly wrong with his organ systems.”

David Bernhardt, UW professor of sports medicine, said most incidents of young athletes dying during athletic events are the result of the athletes having an unknown congenital heart defect they were born with.

Erickson said Nickel had almost no chance of being diagnosed, as he had no symptoms.

“I don’t know how they would diagnose this. It’s something so small,” Erickson said. “If you’re lucky, you can be a young person with symptomology, and a skilled doctor will know how to recognize it.”